General Practitioners' prescription of psychotropic drugs among youth in Belgium

Sherihane Bensemmane, Robrecht De Schreye

Keywords: primary care, psychotropic drugs, prescription, youth

Background:

The prescription of psychotropic medication for children and young adults has been increasing in Belgium. Available data suggest a large proportion of these prescriptions are initiated by General Practitioners (GPs), although current guidelines targeting the first line (GPs and pharmacists) advise against the prescription of psychotropic drugs for children and young adults. Heretofore, little is known about the rationale and medical indication of this prescription in general practice. Therefore, we need to investigate GPs' behaviour towards the prescription of psychotropic drugs for children, adolescents and young adults.

Research questions:

To understand for which medical indication psychotropic drugs are prescribed by Belgian GPs.

Method:

A 21 months retrospective population-based study based on data collected by the Belgian network of Sentinel General Practices (SGP) on all 0 to 23 years old patients consulting their GPs for psychotropic medications. Descriptive statistics were performed.
The questionnaire was created in collaboration with BelPEP (Belgian Psychotropic Experts Platform).

Results:

During the study period 86 cases were reported, corresponding to an incidence rate of 10 per 10000 person-years. Overall, 56% of patients were female. The average age was 17 (IQR 14-21).
Antidepressants were the main psychotropic prescribed treatment (47.7%), followed by psychostimulants (29.1%), and antipsychotics (23.3%). 31.4% of psychotropic drug prescriptions were associated with attention deficit hyperactivity disorder (ADHD), 20% with depression disorder, 19.7% with insomnia, 18.6% with depressive complaints (patients), 15.1% with anxiety disorder.
73.2% of antidepressants prescription were made by GPs, 62,5% for sedative-hypnotic drugs, 42.9% for anxiolytics, 25% for antipsychotics, and 8% for psychostimulants. Non-medical treatment (e.g. Psychologist) started or will be launched in 67.4% of reported cases.

Conclusions:

During the study period, antidepressants were the main class of prescribed psychotropic medication. Furthermore, mood disorders (e.g. depression, anxiety) were preponderant indications justifying prescription. Although guidelines advise GPs to avoid initiating psychotropic medication, they often report being the initial prescriber.

Points for discussion:

The role of GPs in prescribing of psychotropic medications

Psychotropic medication among youth